Ms Patricia Rickard-Clarke:

Safeguarding Ireland welcomes the opportunity to appear before the health committee. I am the chair of Safeguarding Ireland, and I am joined by Annmarie O’Connor, programme manager, and Mervyn Taylor, who is a board member and was formerly CEO of Sage Advocacy. We appear today in the aftershock of the "RTÉ Investigates" documentary, "Inside Ireland’s Nursing Homes", which follows the Grace, Emily and Brandon cases, and the risks to nursing home residents during the Covid-19 pandemic.

Safeguarding Ireland has its origins in the aftermath of the investigation into the adult abuse issues in the Áras Attracta care facility and was designed to bring together perspectives of how adult safeguarding could be addressed in health and social care services. From the start, stakeholders recognised that adult abuse was occurring beyond health and social care and more broadly across all sectors of Irish society. These very harrowing cases give only a partial insight into the extent of adult abuse.

The committee’s focus is on gaps in policy and legislation, but I want to first underline the urgent requirement to move beyond analysis to implementing a comprehensive response to adult abuse across all sectors of society. An adult safeguarding Bill introduced in 2017 could have addressed many of the issues that remain of urgent concern. In 2022, Safeguarding Ireland published the document, Identifying Risks - Sharing Responsibilities, which identified the gaps and proposed an overarching response in the form of adult safeguarding legislation and the establishment of an independent adult safeguarding authority. In April 2024, the Law Reform Commission published its comprehensive analysis of the gaps in policy and legislation, proposed draft adult safeguarding legislation and pointed to the need for an adult safeguarding authority. In May 2024, the Joint Committee on Disability Matters published its report, Ensuring Rights Based Adult Safeguarding in Ireland. It also recommended establishment of a national safeguarding authority.

It is evident from Safeguarding Ireland’s engagement with the public and our national safeguarding advisory committee, which is a cross-sectoral group of almost 40 national organisations, that there are very extensive legal and policy gaps in adult safeguarding, which extend far beyond health and social care. Safeguarding Ireland does not provide a service to the public, yet almost every day it receives concerns from professionals, organisations, family members and other members of the community concerned for the safety of adults at risk. These concerns cover a broad range of abuse types, suggestive of very serious violations of human rights. The alleged harms occur, in the main, in the community, with a component also relating to people in residential care. The alleged perpetrators are very often close family members or trusted others. Often two or more abuse types occur together. Concerns also relate to the provision of services to adults at risk by bodies not funded by the HSE or covered by HSE or health policy.

While Safeguarding Ireland sometimes refers cases of high risk or urgency to An Garda Síochána, more often it signposts to a diverse array of organisations that may have some partial support to offer. In many cases, the concern is sent to Safeguarding Ireland after other avenues have already been investigated. Safeguarding Ireland often refers to relevant legislation or policy, including, in particular, the Criminal Justice (Withholding of Information on Offences against Children and Vulnerable Persons) Act 2012 and the Criminal Justice Act 2011. We also refer to the HSE’s policy on safeguarding vulnerable persons at risk of abuse. There is no single authority on adult safeguarding in Ireland. Getting support or resolution with a concern about the abuse of a vulnerable person requires navigating a Byzantine system where no single body is responsible or has the authority, expertise or resources to resolve the issues.

With regard to the ongoing alleged abuse of adults at risk, there is no relevant legislation. All that exists is the HSE’s 2014 policy which is acknowledged as being outdated, limited in scope and narrow in its application and interpretation. Increasingly, we advise people who contact us about an ongoing risk of harm to an adult to contact An Garda Síochána.

In addition, Safeguarding Ireland receives ongoing queries related to governance, compliance, organisational policy, legislation and training. Organisations and professionals across all sectors and disciplines are encountering adult abuse. They want to respond. They want to know who to refer to and they want assurance that the referral will be acted on. Again, I emphasise, there is no single authority in this regard, no central source of expertise and guidance.

As I mentioned, Safeguarding Ireland published a comprehensive discussion document on the gaps that exist in adult safeguarding in 2022. It evidenced a legislative void in terms of authority to act effectively in safeguarding situations. It showed existing regulations fall far short in respect of the settings to which they apply, the types of abuse they can deal with and their legislative basis. Even where organisations have relevant powers to act, there is an apparent lack of proactivity. There are major gaps relating to co-ordination and co-operation. There are serious gaps in both corporate and individual accountability, self-neglect, coercive control, financial abuse, data sharing and recognition of independent advocacy. There are also deficits in the implementation of the Assisted Decision-Making (Capacity) Act.

The main gaps are the absence of legislation and of an independent adult safeguarding authority. We are agreed, across the range of groups that we work with, that the current safeguarding policy being developed by the Department of Health, while welcome, is not the level of response required to address the ongoing shortcomings in adult safeguarding. This policy is too narrowly focused on just health and the policy has no legislative powers of enforcement or conviction.

The appropriate overarching response that needs to be taken is the establishment of a national safeguarding authority which must be an independent statutory agency with functions and powers in relation to adult safeguarding, to protect people from harm, abuse and exploitation. Its main functions must be to receive reports of actual or suspected abuse or harm occurring in any sector; to respond to reports and ensure that action is taken; to have the power to direct the HSE and other statutory or non-statutory bodies to take actions to safeguard at risk adults; to have a co-ordinating role and conduct serious incident reviews, which is vital for transparency, accountability and improvement; to set standards and monitor compliance; to assist with developing safeguarding plans; to put in place preventative measures; and to have oversight of data collection, research, training, education and awareness.

The other overarching development that needs to occur is to progress implementation of the Law Reform Commission's report on a regulatory framework for adult safeguarding. Safeguarding Ireland again asks the Government, as a matter of urgency, to use the mechanisms of the crossdepartmental Cabinet Committee on Health to establish an interdepartmental working group on adult safeguarding led by the Department of Health and working closely with the Department of justice, the Department of Social Protection and the Department of Children, Disability and Equality and in close consultation with Safeguarding Ireland. The twin objectives are to progress adult safeguarding legislation which covers all Government Departments and agencies of the State based on the draft legislation developed by the Law Reform Commission; and to plan the establishment of an independent adult safeguarding authority, as provided for in the legislation.

Other State bodies with significant roles in the overall adult safeguarding architecture that need to be centrally involved in an inter-agency working group include the Data Protection Commission; HIQA; the HSE's National Safeguarding Office and the National Independent Review Panel; the Policing and Community Safety Authority; An Garda Síochána; the Decision Support Service; the Central Bank of Ireland and the Financial Services and Pensions Ombudsman. The working group should progress the establishment of an independent adult safeguarding authority; the completion and enactment of adult safeguarding legislation, which is already substantially drafted in the LRC report; the completion and application of a statutory framework for adult safeguarding which includes new offences, including an offence of neglect, ill-treatment, intentional abuse, reckless endangerment, withholding of care and-or the necessities of care or practices or systems which create the conditions in which such offences become normalised; an offence of exposure to risk of serious harm or sexual abuse; an offence of coercive control that extends to a broader range of relationships beyond the Domestic Violence Act 2018; and an offence of coercive exploitation to include financial exploitation.

We must give adult safeguarding the same legislative and policy priority accorded to domestic abuse. The development of Cuan provides a very useful roadmap. Safeguarding Ireland is asking this committee to apply its resources and authority to progress, with urgency, the establishment of the above working group and for it to commence its work this autumn. We have included a draft roadmap in the documentation we sent to the committee. We will develop this into a briefing document and provide it to the committee in September.